Charles Gordon, MD, CEO of Tyler, Texas-based Precision Spine Care, is a board-certified neurosurgeon and founder of the Texas Spine & Joint Hospital in Tyler. Throughout his career, Dr. Gordon has remained on the cutting edge of clinical and business trends in spine and neurosurgery.

Here, he discusses the biggest issues for healthcare today and where he sees the best opportunity for future growth.

Three big business trends affecting healthcare:

1. Consolidation of regional systems. This year in Texas, we saw the merger of two of the largest healthcare systems in the country (Baylor Scott and White and Herman Memorial). This new entity will be a staggeringly large system with dozens of hospitals, hundreds of facilities and thousands of providers. These mega-systems will have superior pricing power and obvious advantages in market share. While I don't see this as the demise of independent physicians and medical groups, those seeking to maintain independence will have to come to terms with being disadvantaged from a credentialing and pricing perspective. It seems that one key to succeeding independently is to work creatively and cooperate with the larger systems, while appealing directly to consumers. Add to this trend the recent alignment of CVS with Aetna, and it is clear that we are in for some interesting times as payers are getting into the healthcare delivery business themselves.

2. Practice integration. While not new, I see more logic in integrating surgical and non-surgical practices. As surgeons work closely with complementary fields such as physical medicine and rehabilitation, pain management, rheumatology, etc., patients benefit from a broader resource pool with more non-surgical options. I expect to see more insurance scrutiny for surgical recommendations and having non-surgeons in the same practice can help support good patient care and compliance with insurance requirements.

3. Blended specialty. I think we are witnessing the early stages of a blended specialty where interventional pain physicians are becoming more aggressive and surgeons are embracing less invasive techniques. I suspect this will lead to further overlap in the fields. We see interventional pain physicians and surgeons alike performing MILD decompression and placing interspinous spacers, not to mention vertebroplasty and neuromodulation. As more work is done by both groups in an outpatient setting, I see this trend accelerating.

Growth opportunities:

We believe that with interdisciplinary consolidation [there] is also an opportunity for value creation. Bringing like-minded physicians in complementary specialties together not only improves patient convenience, but [also] achieves some scaling efficiency and reduces overall costs.

Finally, as readers of Becker's surely know, there appears to be continued regulatory and consumer support in favor of ASC-based procedures over those done in a traditional hospital setting, when appropriate. Technical improvements also are enabling this trend. We see this as a continued opportunity in select markets.

For a deeper dive into the future of spine, attend the Becker's 17th Annual Future of Spine + Spine, Orthopedic & Pain Management-Driven ASC in Chicago, June 13-5, 2019. Click here to learn more and register.